Antibiotics not effective for many coughs

Jun 22 2005

In a study of more than 500 patients who were suffering from acute bronchitis or pharyngitis it was found that whether or not antibiotics were prescribed, the irritating bouts of coughing still continued for an average of almost 12 days after the visit to the doctor.

Because of the overuse of antibiotics, some drugs have been rendered ineffective, requiring doctors to deploy stronger and stronger antibiotics and this is cause for concern.

Study author Dr. Paul Little of the University of Southampton, England, says that antibiotic prescriptions for lower respiratory tract infections account for 55 percent of excess prescriptions in the United States, wasting some $726 million a year. A typical prescription can cost anything from $50 to $100.

Researchers say there are severe infections where antibiotics can help, but the drugs are routinely over prescribed for deep coughs and flu associated with lower respiratory infections, because patients ask for them.

Only small studies have previously been performed examining the drugs' effectiveness for patients with coughs bad enough to go the doctor, these account for 3 percent of outpatient doctor visits.

Little says the challenge now is for clinicians and researchers to decide which groups are at risk of adverse outcomes, and identify those patients who might selectively benefit from immediate antibiotic prescription.

For a few patients in the study, the illness lasted 17 days or longer after the visit to the doctor. Prior to the visit, the average duration of the illness was nine days. Pneumonia patients, for whom antibiotics use is well established, were excluded from the study.

In an attempt to discover if informed patients would be less demanding of antibiotics, the researchers gave half the participants leaflets explaining the issues involved but the information had little impact on patients' attitudes.

However, it was found that patients who recovered without the drugs were more likely to become disenchanted with antibiotics.

More than half the study participants not given antibiotics decided they would be ineffective anyway.

In contrast, three quarters of those who took the drugs continued to believe in their effectiveness.

The study is published in the Journal of the American Medical Association.